scholarly journals Drive-Through Model for Anticoagulation Clinics During the COVID-19 Pandemic

2020 ◽  
Vol 26 ◽  
pp. 107602962094747
Author(s):  
Kaveh Rezaei Bookani ◽  
Iva Minga ◽  
Manisha Chander ◽  
Ksenia Hankewych ◽  
Matthew Plassmeier ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Care ◽  
Heart Disease ◽  
Access To Health Care ◽  
Vitamin K Antagonists ◽  
Anticoagulation Therapy ◽  
Access To Health ◽  
Number Of Patients ◽  
Anticoagulation Clinics ◽  
Limit Access

The coronavirus disease of 2019 (COVID-19) has posed a major challenge for providers and patients. A large number of patients with atrial fibrillation, venous thromboembolism, or valvular heart disease are chronically anticoagulated with vitamin K antagonists and rely on frequent follow ups at anticoagulation clinics for management of their anticoagulation therapy. The need for isolation during COVID-19 pandemic can potentially limit access to health care including anticoagulation clinics and directly affect the care of patients on chronic anticoagulation. Therefore, we created a drive-through clinic to bridge the gap of continuation of care and preservation of social distancing precautions. In this manuscript, we report the steps in implementing such initiative which can be applied to other clinics during a pandemic.

Structural Impairments That Limit Access to Health Care for Patients With Disabilities

JAMA ◽  
2007 ◽  
Vol 297 (10) ◽  
pp. 1121 ◽  
Author(s):  
Kristi L. Kirschner ◽  
Mary Lou Breslin ◽  
Lisa I. Iezzoni
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Access To Health ◽  
Limit Access

scholarly journals Out-of-pocket Payments for Health Care Under the National Health Insurance Scheme in Ghana: What Do Clients Pay for?

2020 ◽  
Author(s):  
Patricia Akweongo ◽  
Moses Aikins ◽  
Kaspar Wyss ◽  
Paola Salari ◽  
Fabrizio Tediosi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Facility ◽  
National Health Insurance ◽  
Access To Health Care ◽  
National Health Insurance Scheme ◽  
Health Facilities ◽  
Insurance Scheme ◽  
Access To Health ◽  
Out Of Pocket Payments

Abstract Background: The introduction of social health insurance in developing countries is an important policy to improve financial access to health care. In 2003, Ghana implemented a national health insurance scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments by insured clients is one such challenges of the scheme. This study seeks to examine the types of services that these unauthorized charges are made for, who pays these charges and how much clients pay out-of-pocket.Methods: This was a descriptive cross-sectional health facility survey. A total of 2066 respondents were interviewed using structured questionnaires at the point of health care exit in the Ashanti, Northern and Central regions of Ghana. Health facilities of different levels were selected from 3 districts in each of the three regions. Data were collected between April and June 2018. Using Epidata and STATA Version 13.1 data analyses were done using multiple logistic regression and simple descriptive statistics and results presented as proportions and means.Results: Of all respondents in the study 49.7% reported paying out-of-pocket for out-patient health care while 48.6% of insured clients paid out-of-pocket. 42% of the insured poorest quintile also paid out-of-pocket. Respondents suffered fever-malaria like symptoms (45.7%). Insured clients paid for consultation (75%) and drugs (68.5%) and 34.9% purchased drugs outside the health facility visited. The unavailability of the drugs (67.9%) and drugs not covered by the NHIS (20.8%) led to out-of-pocket payments. On average patients paid GHS33.00 (USD6.6) out-of-pocket. Compared to the Northern region, patients living in the Ashanti region were 4.4 times more at odds to pay out-of-pocket for health care. Conclusions: Insured clients of Ghana’s NHIS seeking health care in accredited health facilities make out-of-pocket payments for consultation and drugs that are covered by the scheme. The out-of-pocket payments are largely attributed to unavailability of drugs at the facilities. These out of-pocket payments occur in disadvantaged regions, among individuals and in all health facilities. Out-of-pocket payments under NHIS leads to inequity in access to health care.

How comprehensive are the basic packages of health services? An international comparison of six health insurance systems

2002 ◽  
Vol 7 (3) ◽  
pp. 133-142 ◽  
Author(s):  
Marc Polikowski ◽  
Brigitte Santos-Eggimann
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Universal Access ◽  
Social Health Insurance ◽  
Initial Report ◽  
Access To Health ◽  
Out Of Pocket Payments ◽  
Using Data ◽  
Access And Affordability

Objectives: Interest in the composition of the health care menu has grown. Its outwardly comprehensive nature is as rhetorical as the slogans of universal access and affordability. This paper summarizes the international part of a report to the Swiss government, in which we explored the basic package of services covered by social health insurance in France, Germany, Israel, Luxembourg, The Netherlands and Switzerland. The aim of the initial report was to check the appropriateness of the Swiss catalogue, with special attention to the risk of unequal access to health care by rationing of effective services. In this paper, we highlight the major differences in service coverage between the countries and address the possible factors explaining those differences. Methods: The contents of the basic packages of the six countries were compared using data from government ministries and sickness funds. Results: Coverage is most comprehensive in Germany and Switzerland; these are also the countries with the greatest total health expenditure. Three countries separated nursing care from other types of health care by creating an independent insurance scheme. Some health care benefits are also covered under the heading of social care. High out-of-pocket payments are increasingly used as hidden rationing instruments. Conclusions: The present comparison highlights the multi-factorial character of the choices made in six countries in order to keep their health care menu within the possibilities offered by available resources.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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